The Chicago Cancer Health Equity Collaborative (ChicagoCHEC) has helped reduce colorectal cancer disparities on Chicago’s south side, assisted Latino men shed unwanted pounds, and extinguished men’s habit of lighting up since its initiation five years ago.
More innovative health care programs will be implemented in the next five years, as the National Cancer Institute (NCI) has provided $17.7 million to renew ChicagoCHEC’s grant. A partnership between the University of Illinois Chicago, Northeastern Illinois University and Robert H. Lurie Comprehensive Cancer Center at Northwestern University, the collaborative is the first of its kind in the Midwest.
Chicago communities that are low-income or predominantly African American or Latino face cancer death rates up to double the national average, according to the Illinois Department of Public Health. ChicagoCHEC’s new grant will engage communities that are disproportionately impacted by cancer health inequities in Chicago with cancer-related programs and outreach activities, and coordinate research education and mentoring opportunities to advance a pipeline of diverse students and early career faculty in cancer research careers.
Over the next five years, ChicagoCHEC will implement several new programs, including the development of an innovative smartphone health application (known as mHealth apps), called WeCanManage, to empower cancer survivors with disabilities to proactively manage their disease and its consequences as a chronic condition. To date, no mHealth self-management apps have been developed to meet the needs of cancer survivors with disabilities, said Susan Magasi, PhD, associate professor of occupational therapy and disability studies at UIC and member of the University of Illinois Cancer Center’s Cancer Prevention and Control Program, who will lead the project.
Of the estimated 16.9 million cancer survivors in the United States, about 40% live with long-term physical, cognitive, psychological and social consequences of cancer and its treatments. This, Magasi said, can lead to long-term disability. Research indicates that self-management interventions can assist people – including those with cancer – acquire the knowledge and skills needed to manage symptoms like pain, fatigue, anxiety and decreased mood.
“People with disabilities are an unrecognized health disparities population and are often excluded from the cancer health equity agenda,” Magasi said. “Indeed, cancer survivors indicate that their long-term disability needs are inadequately addressed across the cancer care and survivorship continuum.
“The WeCanManage research project is an opportunity to enhance the cancer community’s understandings of this population and to develop evidence-informed interventions to better meet the needs of people with the ‘double whammy’ of cancer and disability.”
Collaborating with Magasi will be Tamara Hamlish, PhD, research scientist in the University of Illinois Cancer Center’s survivorship program. Other program co-principal investigators (PIs) are Rachel Adler, PhD, associate professor of computer science at NEIU; and David Victorson, PhD, associate professor of medical social sciences, Northwestern. A team of “survivor scientists” (people living with disability and cancer) will also participate in the app development.
A second project, entitled SHARED (Supporting High Risk African American Men in Research & Engagement in Decision Making for Lung Cancer Screening) will be developed to reduce lung cancer inequities across diverse populations of high-risk smokers, especially racial and ethnic minorities.
Black men, who have the highest rate of lung cancer morbidity and mortality, will be engaged as “citizen scientists” to improve the understanding of lung cancer screening at Mile Square Health Centers, a group of 13 Federally Qualified Health Centers (FQHC) associated with the University of Illinois Hospital and Health Sciences System at UIC.
“Citizen Scientists aren’t formally trained but they have proven to be invaluable in increasing communities’ knowledge and awareness of research, building trust in scientific research, and informing areas of research design and ethics,” said Karriem Watson, DHSc, MS, MPH, Associate Director, Community Outreach and Engagement, the Cancer Center, and Associate Executive Director of Mile Square Health Center/UI Health, who is leading the project.
The U.S. Preventive Services Task Force recommends low dose helical computed tomography (LDCT) screening to detect lung cancer in its earliest stages among adults aged 55 to 80 who have a history of smoking. Few studies, however, have addressed how to engage high-risk Black men and their clinical care providers in LDCT, Watson said. The Centers for Medicare and Medicaid Services (CMS) requires a shared decision-making process for all patients prior to LDCT screening, and the “citizen scientists” will leverage their social networks to support Black men to undergo lung cancer screening.
Phoenix Matthews, PhD, professor of population health nursing science and Associate Dean for Equity and Inclusion at the UIC College of Nursing and member of the University of Illinois Cancer Center’s Cancer Prevention and Control program, will serve as co-leader on the project. Additional team members include Josef Ben Levi, PhD, lecturer at NEIU; David Odell, MD, MMSc, associate professor of thoracic surgery at Northwestern’s Feinberg School of Medicine; and Marcus Murray, MPH, founder and executive director of Project Brotherhood, which will serve as the lead community stakeholder to inform the project. Project Brotherhood has been engaging Black men and their families in comprehensive health and wellness programs for more than 20 years.
ChicagoCHEC will also initiate a pilot research program to provide the groundwork for an ecological analysis of variation in microbiome diversity in Chicago.
“Utilizing researchers at multi-institutions, the study will evaluate serial changes in intestinal and oral gut microbiota among 50 hematopoietic stem cell transplant patients selected from two widely diverse areas that are each characteristic of large populations in the Chicago metropolitan area,” said John Galvin, MD, MPH, MS, assistant professor of clinical medicine and member of the University of Illinois Cancer Center’s Translational Oncology program who is on the project team. “The study will demonstrate the feasibility of analyzing the association of microbiome diversity with early clinical outcomes among stem cell transplant patients residing in the Chicago area.
“These findings are expected to better elucidate the role that area characteristics, as reflected by geographic location, may play in intestinal gut microbiome diversity.”
Along with Galvin, other project co-PIs will be Jonathan Moreira, MD, Assistant Professor of Medicine, Robert H. Lurie Comprehensive Cancer Center Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine; Hardik Marfatia, PhD, Assistant Professor, Department of Economics, College of Arts and Sciences, Northeastern Illinois University; and Patrick Casey Seed, MD, PhD, Children’s Research Fund Professor of Basic Science, Professor of Pediatrics and Microbiology-Immunology, Chief of Infectious Diseases, Department of Pediatrics, Associate Chief Research Officer for Basic Sciences, Stanley Manne Children’s Research Institute, Chicago.
Since its launch in 2015, the collaborative infrastructure between UIC, NEIU and Northwestern has seen rapid growth, and John Stewart, MD, MPH, Professor of Surgery, Associate Director for Clinical Sciences at the Cancer Center who serves as a co-leader of the ChicagoCHEC grant, does not anticipate it slowing down.
“We want to leverage the momentum forged by the initial U54 award and its diverse team of faculty, students, and partners, and connectivity to Chicago’s underserved communities to drive innovative cancer research, research education, and community outreach and engagement that cuts across disciplinary and institutional boundaries to reduce health disparities in cancer in the city of Chicago,” he said. “We’re excited for the next five years.”
ChicagoCHEC will continue to be co-led by community-oriented physician-scientists and researchers Marian Fitzgibbon, PhD, Professor of Pediatrics and Health Policy and Administration, and Associate Director of Population Health at the University of Illinois Cancer Center, and Stewart; Melissa Simon, MD, MPH, the George H. Gardner, MD, Professor of Clinical Gynecology, director of the Center for Health Equity Transformation, and co-leader of the Cancer Control and Survivorship Program at Robert H. Lurie Comprehensive Cancer Center of Northwestern University, and Joseph Feinglass, PhD, Research Professor of Medicine and Preventive Medicine at Northwestern University; and Christina Ciecierski, PhD, Professor of Economics, and Lidia Filus, PhD, Professor and Chair of Mathematics, Northeastern Illinois University.